The association of neurologists with headache health care utilization and costs

Abstract

Compared with those without a neurologist, headache patients who visit neurologists had a transient increase in hospitalizations, but the same ED utilization. Confounding by severity is the most likely explanation given the non-headache-related cost trajectory. Claims-based risk adjustment will likely underestimate disease severity of headache patients seen by neurologists.

Understanding Data and Opportunities Focused on Value

“… 15 Furthermore, despite adjusting for morbidity, we continued to find higher costs and health care utilization in our neurology and headache subspecialty subgroups than in primary care. 13 , 15 As in our analysis, pharmacy costs were previously cited as a main driver of headache costs. 9 …”

“…15 Furthermore, despite adjusting for morbidity, we continued to find higher costs and health care utilization in our neurology and headache subspecialty subgroups than in primary care. 13,15 As in our analysis, pharmacy costs were previously cited as a main driver of headache costs. 9 Another principal finding of this work was that the currently available data were necessary but insufficient to determine the value of headache care within the organization.…”

Understanding Data and Opportunities Focused on Value

“… 15 Furthermore, despite adjusting for morbidity, we continued to find higher costs and health care utilization in our neurology and headache subspecialty subgroups than in primary care. 13 , 15 As in our analysis, pharmacy costs were previously cited as a main driver of headache costs. 9 …”

“…15 Furthermore, despite adjusting for morbidity, we continued to find higher costs and health care utilization in our neurology and headache subspecialty subgroups than in primary care. 13,15 As in our analysis, pharmacy costs were previously cited as a main driver of headache costs. 9 Another principal finding of this work was that the currently available data were necessary but insufficient to determine the value of headache care within the organization.…”

Healthcare providers’ perspectives on headache care in Azerbaijan: results of a national cross-sectional survey

“…The predominance of hospital-based respondents and the absence of community-based healthcare professionals in the present survey may reflect similar organizational challenges, although the convenience sampling design precludes conclusions regarding the national distribution of the headache workforce. Objective workforce mapping and population-based studies are required to determine whether comparable urban–rural disparities exist in Azerbaijan ( 3–5 ).…”

Claims data analyses unable to properly characterize the value of neurologists in epilepsy care

“…The importance and difficulty of proper risk adjustment have been highlighted in recent investigations of claims data for stroke patients and patients with headache. 12,19 Several epilepsy-specific considerations make measurement of care quality particularly elusive for this patient population. Classic measures of disease severity such as epilepsy etiology, seizure frequency, and seizure type 20 are not readily abstracted from insurance claims.…”

Understanding Data and Opportunities Focused on Value

“… 15 Furthermore, despite adjusting for morbidity, we continued to find higher costs and health care utilization in our neurology and headache subspecialty subgroups than in primary care. 13 , 15 As in our analysis, pharmacy costs were previously cited as a main driver of headache costs. 9 …”

“…15 Furthermore, despite adjusting for morbidity, we continued to find higher costs and health care utilization in our neurology and headache subspecialty subgroups than in primary care. 13,15 As in our analysis, pharmacy costs were previously cited as a main driver of headache costs. 9 Another principal finding of this work was that the currently available data were necessary but insufficient to determine the value of headache care within the organization.…”

Healthcare providers’ perspectives on headache care in Azerbaijan: results of a national cross-sectional survey

“…The predominance of hospital-based respondents and the absence of community-based healthcare professionals in the present survey may reflect similar organizational challenges, although the convenience sampling design precludes conclusions regarding the national distribution of the headache workforce. Objective workforce mapping and population-based studies are required to determine whether comparable urban–rural disparities exist in Azerbaijan ( 3–5 ).…”

Claims data analyses unable to properly characterize the value of neurologists in epilepsy care

“…The importance and difficulty of proper risk adjustment have been highlighted in recent investigations of claims data for stroke patients and patients with headache. 12,19 Several epilepsy-specific considerations make measurement of care quality particularly elusive for this patient population. Classic measures of disease severity such as epilepsy etiology, seizure frequency, and seizure type 20 are not readily abstracted from insurance claims.…”

Understanding Data and Opportunities Focused on Value

“… 15 Furthermore, despite adjusting for morbidity, we continued to find higher costs and health care utilization in our neurology and headache subspecialty subgroups than in primary care. 13 , 15 As in our analysis, pharmacy costs were previously cited as a main driver of headache costs. 9 …”

“…15 Furthermore, despite adjusting for morbidity, we continued to find higher costs and health care utilization in our neurology and headache subspecialty subgroups than in primary care. 13,15 As in our analysis, pharmacy costs were previously cited as a main driver of headache costs. 9 Another principal finding of this work was that the currently available data were necessary but insufficient to determine the value of headache care within the organization.…”

Healthcare providers’ perspectives on headache care in Azerbaijan: results of a national cross-sectional survey

“…The predominance of hospital-based respondents and the absence of community-based healthcare professionals in the present survey may reflect similar organizational challenges, although the convenience sampling design precludes conclusions regarding the national distribution of the headache workforce. Objective workforce mapping and population-based studies are required to determine whether comparable urban–rural disparities exist in Azerbaijan ( 3–5 ).…”

Claims data analyses unable to properly characterize the value of neurologists in epilepsy care

“…The importance and difficulty of proper risk adjustment have been highlighted in recent investigations of claims data for stroke patients and patients with headache. 12,19 Several epilepsy-specific considerations make measurement of care quality particularly elusive for this patient population. Classic measures of disease severity such as epilepsy etiology, seizure frequency, and seizure type 20 are not readily abstracted from insurance claims.…”